CYP2C19 polymorphism impacts response to PPI Tx in GERD

(HealthDay)—CYP2C19 polymorphism impacts response to proton pump inhibitor (PPI) treatment in gastroesophageal reflux disease (GERD), with lower efficacy rates for rapid metabolizer (RM) genotypes, according to a study published online Nov. 18 in the Journal of Gastroenterology and Hepatology.

Hitomi Ichikawa, M.D., from the Hamamatsu University School of Medicine in Japan, and colleagues conducted a meta-analysis to examine whether the CYP2C19 RM genotype is a risk factor for GERD patients who are refractory to PPI therapy.

The researchers found that in intention-to-treat (ITT) and per-protocol analyses, the total efficacy rate of PPIs was 56.4 and 63.8 percent, respectively, for GERD, including reflux esophagitis (RE) and non-erosive reflux disease. Between the CYP2C19 genotypes, there was significant variation in efficacy rates (ITT analysis: RMs, 52.2 percent; intermediate metabolizers, 56.7 percent; and poor metabolizers [PMs], 61.3 percent; P = 0.047). Compared with CYP2C19 PMs, RMs had an increased risk of being refractory to PPI therapy among RE patients (odds ratio, 1.661; P = 0.040).

"Individualized dosing regimen with PPIs based on CYP2C19 genotype might be a valid therapeutic strategy for overcoming insufficient gastric acid inhibition," the authors write.